This comprehensive Center grant application (P60), submitted in response to RFA MD-03-003, "Project EXPORT," will promote high quality, culturally competent, theoretically sound, and programmatically relevant research through a series of projects that promise to shed important light on the barriers as well as facilitators to improved health status and functioning of Amedcan Indians and Alaska Natives. This new, explicitly focused center, through its synergistic relationship with the American Indian and Alaska Native Programs (AIANP) at the UCHSC and our larger network of organizations/institutions serving AlAN populations will significantly increase both the extent of as well as subsequent capacity for health disparities research undertaken by American Indian/Alaska Native investigators, focused on a racial minority population among the most in need. Towards these ends, the specific aims are to: 1). Provide an administrative structure that promotes excellence in research and research capacity-building specific to improving the health and well-being of American Indian and Alaska Native communities. 2) Plan and carry out an interdisciplinary, culturally grounded, problem-oriented research program of major scientific and programmatic importance to the health status and functioning of American Indians and Alaska Natives, with particular emphasis on quality of diabetic care for AI youth; telepsychiatry; documenting obesity among At infants and children; cancer; chlamydia screening with AI males; increasing fitness among urban AlAN youth; smoking cessation; understanding of the performance properties of a widely used health quality measure, and assessing/improving the quality of mental health care for AI children 3) Structure and pursue career development opportunities for American Indian and Alaska Native investigators through intensive mentorship within the applied health disparities research program described herein. 4) Disseminate the results of this work as a means of guiding the design, conduct, and interpretation of future research specific to understanding and reducing the health disparities that plague American Indian and Alaska Native communities. 5) Assist individuals, provider organizations, and other institutions of higher education in planning and implementing similar health research and in maximizing the relevance of its outcomes for application in American Indian and Alaska Native communities.